Care Home: Carlton Specialist Care Centre

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What the care home does well To make sure people`s needs can be met these are assessed before coming to live in the home. Staff from the home also go and spend time with people to get to know them before they move. To make sure people receive the care they need and want they have a Person Centred Plan, which, they are, assisted to complete. This shows staff how they like to be cared for and what they like to do. People look at their Person Centred Plans regularly and these are changed to show people`s choices and preferences or any progress they have made. As part of living an ordinary lifestyle people are supported to use ordinary community based leisure services wherever possible. Some people are supported to go food shopping and to prepare their own meals. To make sure people`s health needs are met they are encouraged and supported to use ordinary community based healthcare services. People living in the home are involved and have a say in selecting new staff to work in the home. People are protected by the way staff are recruited and selected. People are also protected by the way medicines are dealt with and the staff are trained to give medicines safely. To make sure people are safe they are cared for by trained staff. People have their own space as they want it and they are surrounded by their own possessions. What has improved since the last inspection? People living in the home are better protected as the way staff are recruited and selected, as improved and appropriate references are undertaken before they are employed. People are safer as Safeguarding training in how to protect people from abuse and First Aid training has been given to staff. People are cared for by staff that are suitably trained, as there is now Training and Development officer who plans training and makes sure the right training is provided for staff. People can be sure that they don`t have too much medicine when they are agitated as this is now monitored and reviewed regularly. People live in a safer home as all of the remedial work required has been completed and checked by the Local Authority Contracts Monitoring Department. Information about people living in the home is now safer and is kept in a locked place. People are also safer as staff have now had fire drills and Fire Awareness training. People living in the home now have a place in the garden that is safe and secure.The outside of the home looks much better and the fences have been painted and some parts of the garden area made better. People will have a consistent approach to the way the home runs as the Acting Manager has now made an application to be registered. The way the home looks and runs, including health and safety is now regularly monitored by the Operations Manager and acted upon by the people providing the serviced. What the care home could do better: The Person Centred Plans and monthly key worker reviews show people have a say in what happens to them and how they live their lives. However, the daily records do not contain descriptive words to reflect and show people`s choices and preferences or any decisions they make on a day- to -day basis. The Training and Development Officer says they are going to arrange some Autism Specific Training for staff. They also said they would look into having a dedicated training budget for the home to enable them to do this. Some people are encouraged and assisted to go food shopping and help in food preparation. The affect of diet on behaviours was discussed and the Acting Manager said they would research this. A lot of work has already been completed to make the home safer and look better, however, the back wall, and the garden surrounding the premises still requires some attention. To further protect people`s best interests the acting manager said in future two signatures would be provided when recording financial transactions It is acknowledged that the home has a quality assurance monitoring system and people have the opportunity to comment on the care provided in the monthly key-worker reviews, the reviews, and residents meetings. However there was no evidence of the views of people living in the home and their relatives and other visiting professionals on the quality of services provided being sought. A report reflecting the views of people living in the home, their relatives and others on the quality of care is not provided. CARE HOME ADULTS 18-65 Carlton Specialist Care Centre 18 Greenway Milnsbridge Huddersfield HD3 4RZ Lead Inspector Tony Railton and Rob Padwick Unannounced Inspection 10th October 2008 11:15 Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carlton Specialist Care Centre Address 18 Greenway Milnsbridge Huddersfield HD3 4RZ 01484 649899 01484 649899 carltonshare@btconnect.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (If applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Carlton Nursing Homes Ltd Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD The maximum number of service users who can be accommodated is: 10 8th April 2008 2. Date of last inspection Brief Description of the Service: Carlton Specialist Care Service provides care and support for up to ten people have learning disabilities and who may also display severe behaviours that challenge ordinary community based services. The home aims to provide an individualised service tailored to people’s needs that include encouraging independent living skills and the pursuit of living an ordinary lifestyle. The building has a large open space that is used for activities including table tennis. There are numerous other rooms geared towards specific activities such as a TV room, wet room with hot tub and Jacuzzi, arts and crafts room and a sensory room. People have their own bedroom with en-suite shower room or bathroom. There is a dining room with another seating area and a kitchen. There is car parking to the front and side of the building and a small secure garden to the rear. The home is situated in a residential area of Huddersfield and there are local shops nearby. The home is also on a main bus route and only a few minutes ride from the centre of Huddersfield. People wanting to use the service are given the Service User Guide and Statement of Purpose, which give them information about the home and the services provided. On the 13th October 2008 the providers said the fees ranged from around £1,500 to £2,300 per week but are dependent on individual assessments and care packages. Further information can be obtained by e-mailing carltonshare@btconnect.com Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Following this visit to the service it has been given a Two Star Rating, which means people living in the home experience good quality outcomes. This visit to the home started at 11.15 and ended at 18.15. As part of the visit we looked at a sample of three people’s records that included, assessments, care plans, reviews, daily and medical records. We also looked at a sample of three staff records that included application forms, references, police checks, training and supervision records. Through the course of the visit there was the opportunity to speak to people using the service, the Operations Manager, Acting Manager, senior support workers, care workers and the training officer. Other information looked at included the previous inspection report, service history, the reports from the provider’s visits, and the homes Annual Quality Assurance Assessment. A sample of three people’s medicines were seen and the medication administration system checked. Three people’s finances were seen and checked. A tour of the premises was undertaken and included the garden area outside. This was a very positive visit where a number of improvements were noted. The inspectors would like to take the opportunity to thank people living in the home, the acting manager and the staff team for their hospitality and cooperation throughout the visit. What the service does well: To make sure people’s needs can be met these are assessed before coming to live in the home. Staff from the home also go and spend time with people to get to know them before they move. To make sure people receive the care they need and want they have a Person Centred Plan, which, they are, assisted to complete. This shows staff how they like to be cared for and what they like to do. People look at their Person Centred Plans regularly and these are changed to show people’s choices and preferences or any progress they have made. As part of living an ordinary lifestyle people are supported to use ordinary community based leisure services wherever possible. Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 6 Some people are supported to go food shopping and to prepare their own meals. To make sure people’s health needs are met they are encouraged and supported to use ordinary community based healthcare services. People living in the home are involved and have a say in selecting new staff to work in the home. People are protected by the way staff are recruited and selected. People are also protected by the way medicines are dealt with and the staff are trained to give medicines safely. To make sure people are safe they are cared for by trained staff. People have their own space as they want it and they are surrounded by their own possessions. What has improved since the last inspection? People living in the home are better protected as the way staff are recruited and selected, as improved and appropriate references are undertaken before they are employed. People are safer as Safeguarding training in how to protect people from abuse and First Aid training has been given to staff. People are cared for by staff that are suitably trained, as there is now Training and Development officer who plans training and makes sure the right training is provided for staff. People can be sure that they don’t have too much medicine when they are agitated as this is now monitored and reviewed regularly. People live in a safer home as all of the remedial work required has been completed and checked by the Local Authority Contracts Monitoring Department. Information about people living in the home is now safer and is kept in a locked place. People are also safer as staff have now had fire drills and Fire Awareness training. People living in the home now have a place in the garden that is safe and secure. Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 7 The outside of the home looks much better and the fences have been painted and some parts of the garden area made better. People will have a consistent approach to the way the home runs as the Acting Manager has now made an application to be registered. The way the home looks and runs, including health and safety is now regularly monitored by the Operations Manager and acted upon by the people providing the serviced. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 8 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit to the service. To make sure the service can meet peoples’ personal care needs these are assessed before coming to live in the home. EVIDENCE: A Sample of three people’s records show they have person centred Plans that include a comprehensive assessment of their care and support needs. They also show people are involved in their own assessments that include how they like to be cared for and their likes, dislikes choices and preferences. The records also show staff go and meet and spend time with prospective residents getting to know them before they come to live in the home. The acting Manager and Senior Care staff confirmed this. This good practice is to be commended. The sample of three people’s records show they also have a comprehensive assessment of their care needs and social history completed by the placing authorities. Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 ,9 and 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit to the service. People have a say in what happens to them and how they live their lives and they are supported to take risks as part of living an ordinary lifestyle. Information about them is appropriately kept and is safe. EVIDENCE: Throughout the visit people were observed to be treated with dignity and having their wishes respected. The sample of three peoples records show they have Person Centred Plans, which, they have completed with the assistance of support workers. The Person Centred Plans show people have a say in what they do and how they live their lives. One person’s records show they have communication problems and the Acting Manager said someone who knows them well helps complete the Person Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 12 Centred Plans. There was evidence of pictures been used to help communicate this persons needs. This practice is to be commended. The plans include people’s hopes and aspirations, choices and preferences, likes and dislikes. To make sure people’s needs are met there is a monthly Key –Worker review to look and see if people are happy with their care or to record any changes or progress. The key workers reviews are signed and confirmed peoples’ involvement. Other people including relatives and other visiting professionals have also signed some people’s reviews to show their involvement. The minutes of the residents meetings show people have a say in the running of the home. The daily records however, do not contain descriptive words to reflect and show people’s choices and preferences or any decisions they make about their lives on a day- to -day basis. Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit to the service. People have a say in what they do and how they live their lives and they are supported to use ordinary community based leisure services. People also have a say in the choice of menu. EVIDENCE: A sample of three people’s records and in particular Person Centred Plans and Key-worker reviews and record of activities, show people are encouraged to live as ordinary a lifestyle as possible. One person’s records show they work on a voluntary basis at a local coffee shop. The risk assessments show people are encouraged to take risks as part of living an ordinary lifestyle. This person said they “enjoy” going to work. Another says they “like going out to the shops”. Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 14 The records of activities show people are supported to be part of the community which. includes visits to the local working men’s club. The Acting manager confirmed this. The minutes of the residents’ meetings also confirmed people choose where they would like to go on holiday. Two people’s records show they are supported to do their own food shopping and assist in food preparation. The acting manager said there is the involvement of a dietician with one person doing this because they have had weight problems in the past. This person’s records confirmed this. The affect of diet on behaviours was discussed and the Acting Manager said they would research this. A certificate displayed in the homes kitchen shows it received a Three Star Gold Award following a visit from the Local Authority Environmental Health Department. People were observed enjoying their meals in a relaxed environment choosing to sit where they wanted to. One person said they “go home” and spend time with their relatives regularly. The records confirmed this. One person said they “enjoyed living in the home”, however, they also said “It was time to move on”. They said they have “learned so much” they are now moving into “independent living. The acting manager confirmed this. Another person told the inspectors they are “looking forward to moving into the flat”. Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit to the service. People’s personal and healthcare needs are met and they are protected by the way medicines are dealt with. EVIDENCE: A sample of three people’s Person Centred Plans, monthly Key-Worker reviews and reviews show people’s signatures to show they are involved and have a say in how they are cared for. People’s health records show they are supported to use ordinary community based healthcare services wherever possible. Some people’s records show they are also supported by the Community Learning Disability Nurses and Hospital based Consultants. The service history shows there have been concerns about the use of medicines in the control of behaviours by one Consultant. Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 16 Discussion with the Operations Manager and Acting Manager shows the use of ‘when necessary’ medicines is monitored closely and the medication Monitoring Charts confirmed this. One person’s records showed when they came to the home they had sixteen behavioural episodes a month that needed intervention. However, recent records show no behaviours requiring intervention have been noted. The acting manager said all people’s medicines are monitored and their behaviours are recorded and the home will continue to do this. The reviews and the ABC Behavioural charts confirmed this and show people’s behaviours that need intervention are recorded. People are protected by the way medicines are dealt with as the staff training records show those giving medicines are trained to do so safely. Four people’s medicines, and in particular ‘when necessary ‘ medicines were checked, counted and found to be correct and properly stored and recorded. Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit to the service. What people say is listened to and acted upon and people are protected from abuse and neglect and self harm. EVIDENCE: The service history shows, no complaints have been received by the Commission regarding the home. However, the service history shows there have been two Safeguarding Referrals made by the home to the Local Authority. Through discussion with the Operations Manager, and the Acting Manager found that these have been dealt with appropriately. The minutes of the Safeguarding Meeting confirmed this. The Acting manager said there was an issue with the timing of one referral, however, the Policy and Procedure has been reviewed and senior staff made aware of the Safeguarding protocol. Records show, to further protect people living in the home all staff have now received Safeguarding Training. The training records confirmed this. The record of complaints show that peoples comments are taken seriously and acted upon. One person said if they “had a complaint to make they would see the Acting Manager”. The minutes of the residents’ meetings and staff meetings show people have the opportunity to comment on the running of the home. Staff supervision Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 18 notes also show that staff have the opportunity to comment on the quality of services provided. Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including this visit to the service. People have their own space as they want and they are surrounded by their own possessions. However, the land around the home needs some attention. EVIDENCE: People live in a well maintained home as a tour of the premises found it to be clean and safe. The Gas and Electricity certificates show people live in a home that is safe as these have recently been serviced. Some people showed the inspectors their bedrooms and these were found to be personalised and people are surrounded by their own possessions. One person says they “like their bedroom”. They said they “chose their own colour scheme” and there “own furniture”. Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 20 People have opportunities to enjoy a number of therapeutic activities as a tour of the premises show there is a Hydrotherapy pool/ Jacuzzi. The Acting Manager and Senior Support worker confirmed most people enjoy using the pool. The record of activities also confirmed this. There is also a Sensory Room for people to relax in. This is fitted with lighting and music equipment and ‘Bean bag’ seating. The record of activities shows people use this room on a regular basis. There is a television lounge and an activities room that is regularly used. It was noted that throughout the visit someone living in the home was being assisted to use the activities room with one to one support. This practice is to be commended. The record of activities and risk assessments in the Aromatherapy Room show people enjoy regular Aromatherapy sessions. The Acting Manager says the Aroma Therapy sessions help people to relax and promote positive behaviours. To make the premises safer and more homely it was noted that all of the recommendations and requirements following the previous visit have been completed. The Local Authority Contracts Monitoring Officer confirmed this following a compliance visit. There is a very large space in the centre of the home that is currently used by people for activities such as table tennis and parties. The Acting Manager says the geography of the building although not perfect assists in managing the behaviour of people living in the home as there are so many therapy rooms for people to relax in and for one to one work. To offer more privacy to those living in the home the way of hanging the curtains in some of the bedrooms was discussed as curtains are regularly ‘pulled down’. The acting manager and Senior Support worker say they are looking at alternative ways of hanging the curtains using Velcro so they can rehang quickly without any damage. The fencing around the home has now been painted and there is a small secure garden area with outdoor seating provided for people to enjoy during the summer months. However, the rest of the garden and in particular the raised flower beds/ sensory garden needs attention before people living in the home can enjoy these. The Acting Manager said the wall to the rear of the building that is overlooked by people’s bedrooms is going to be painted and they are looking at ways of improving this area. Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit to the service. Peoples’ needs are met by the numbers and skill mix of staff and they are now protected by the way staff are recruited and selected. EVIDENCE: To make sure people are cared for and supported by trained staff, Staff Training and Development Office has been employed by the home. The Training and Development officer said they plan and organise training and update training for all staff working in the home. To make sure people are safe the training records including training MATRIX shows staff have now had First Aid and Safeguarding Training since the previous inspection visit. To make sure people continue to be safe the training records also how staff have Moving and Handling, Behaviour Management, Food Hygiene, Health and Safety, Infection Control and Fire Safety training. To further protect people living in the home the records also show staff giving medicines have training in how to do this correctly and safely. The Staff training and Development officer said they are looking to provide some specialist training and in particular Autism Specific Training. The training Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 22 catalogue from the National Autistic Association confirmed this. However, they also said the home could do with its own dedicated training budget to allow this specialist training to be provided. A sample of three staff records show they have induction training as soon as they are employed. The Acting Manager confirmed this and said new staff have in house induction training as soon as they start work and then further induction within six weeks. The acting manager also said to protect people living in the home new staff have a ‘mentor’ who they shadow and they are not allowed to do anything by themselves until they have been trained in how to do things safely. Discussion with a new member of staff confirmed this. Staff records also show they have National Vocational Qualifications Level 2 or above. The Acting manager said to make sure have the care and support they require all staff either have a NVQ certificate or are registered on NVQ courses. People are protected by the way staff are recruited and selected as three staff records show that references, police and POVA (Protection of Vulnerable Adults List) checks are taken up before they are employed. One staff record shows someone using the service was involved in the interviewing process and had a say in whether they should be employed. This practice is to be commended. The Acting Manager said there are enough staff planned to be on duty to meet the care and support needs of people living in the home. The staffing rota confirmed this. Throughout the visit staff were observed to be available in sufficient numbers to meet people’s support needs, in a relaxed and unhurried manner. Staff spoken to say they feel there are enough staff on duty for them to do their work properly. One person using the service said “staff are very caring and helpful”. The Senior Support Worker said they are currently undertaking the Registered Managers Award (NVQ Level 4). This practice is to be commended. Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 and 42 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit to the service. People live in a well managed home that is run in their best interests and where their health , safety and well-being is promoted and protected. EVIDENCE: The Acting manager says they have made an application to become the registered manager. The CSCI Registration Team confirmed this. The new Operations manager said the management systems in the home have improved and is more stable than before. They said they visit the home regularly and will continue to do so. A sample of three people’s records show the care management systems have improved since the previous inspection visit. The new Person Centred Plans Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 24 that show people are fully involved in their assessments, care plans and reviews and have a say in what happens to them. The key worker reviews and minutes of residents meetings show people have the opportunity to comment on the services and support provided. Records also show people are involved in the staff recruitment and selection process. To make sure people are safe a sample of three staff records, and discussion with the Training and Development Officer, and Acting manager and the training records show improvements to staff management and training. The person Centred Plans and record of monthly key-worker reviews show people have a say in the running of the home and the opportunity to comment on the quality of services provided. The Acting manager said as well as residents’ meetings people and their relatives’ opinion is sought on the quality of services provided. They went on to say that the response from relatives was very poor. The Acting manager said they are going to collate the information gathered and provide a Quality Assurance Report to reflect peoples comments including people living in the home, their relatives and other People are protected by the way their finances are dealt with as three people’s monies were checked and found to be correct. However, people’s financial transactions only had one counter signature. To make sure people are safe the Operations Manager said Health and Safety issues form part of the Regulation 26 monthly providers’ visit reports and they make sure any recommendations or repairs are acted upon. The Gas and Electric Service Certificates, Fire Drill and Fire Alarm Test records and Regulation 26 monthly providers’ reports show people’s Health , Safety and Well-being is promoted and protected. Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 3 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 2 X 2 3 x Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA7 Good Practice Recommendations The daily records would benefit from an increase in the use of descriptive words to reflect and show people’s choices and preferences and any decisions they make about their lives on a day –to- day basis. As a matter of good practice the Acting Manager said they would discuss the effects of diet on behaviour with the dietician. To make the environment better for people living in the home the garden area and the wall to the side needs some more attention to make it more presentable. To fully meet peoples’ care and support needs staff should have specialist training for example Autism specific and look into having dedicated training budget for the service. To show what people think about the quality of support and services provided the information gathered through satisfaction surveys of people living in the home, their relatives and other people should be collated and a report provided showing what the home did in response to their comments. To further protect people’s best interests and as a matter of good practice two signatures should be obtained following financial transactions. 2 3 4 5 YA17 YA23 YA35 YA39 6 YA41 Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Carlton Specialist Care Centre DS0000064511.V371916.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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